Journal of Nobel Medical College
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Published By Nepal Journals Online

2091-234x, 2091-2331

2022 ◽  
Vol 10 (2) ◽  
pp. 26-32
Author(s):  
Pratap Kumar Roy ◽  
Dharanidhar Baral ◽  
Arjun Gautam ◽  
Sarita Subedi

Background: Obesity and Diabetes Mellitus type 2 have a known association. Yet, the socio-demographic predictors of obesity in special populations like ours (Asian) who have DM remain unclear. The purpose of this study was to determine the socio-demographic predictors of obesity among newly diagnosed Diabetes Mellitus in adults. Materials and Methods: This was a descriptive cross-sectional study conducted in endocrine OPD of Nobel medical college. Total 124 subjects were enrolled who were newly diagnosed Diabetes Mellitus over a period of 1 year. Detailed history was taken for demographic and clinical variables. Height, weight, waist circumference and blood pressure were measured. Besides, Body Mass Index, the dependent variable, was calculated. Subjects were considered to have diabetes based on their fasting and postprandial blood sugar level for the first time. Results: The prevalence of obesity among the study population was 39.5%, overweight was 45.2%. Predictors for this study for obesity were found as abnormal blood pressure and hospital visit after symptoms development. Conclusion: Obesity is a important risk factor for Diabetes Mellitus and higher prevalence of obesity among type 2 diabetes was observed. Predictors for this study for obesity were found as abnormal blood pressure and hospital visit after symptoms development


2022 ◽  
Vol 10 (2) ◽  
pp. 65-69
Author(s):  
Asmita Dawadi ◽  
Simant Lamichhane ◽  
Manoj Humagain ◽  
Pratibha Poudel ◽  
Sita Bhusal

Peripheral odontogenic fibroma (POdF) is a rare benign odontogenic tumor of ectomesenchymal origin which is composed of fibrous connective tissue containing islands, strands or cords of odontogenic epithelium. The lesion is more common among females, commonly seen between the second to fourth decades of life, mostly affecting the anterior region of mandible. Clinically, it may present similar characteristics with other more common gingival lesions such as pyogenic granuloma, peripheral ossifying fibroma and peripheral giant cell granuloma. So, histopathological examination is required for accurate diagnosis. We present here three rare clinical cases of peripheral odontogenic fibroma and their management by complete excision of the lesion with good postoperative outcomes.


2021 ◽  
Vol 10 (2) ◽  
pp. 49-53
Author(s):  
Pramod Chaudhary ◽  
Prakash Kafle ◽  
Narendera Joshi ◽  
Ujwal Gautam

Background: Minimal invasive open lumbar microdiscectomy has been associated with good success rate and low morbidity. The present study is aimed to evaluate the clinical outcome of patients who underwent open minimal invasive open lumbar microdiscectomy for herniated intervertebral disc. Materials and Methods: This is a prospective observational hospital based study of prolapsed lumbar intervertebral disc operated in the department of neurosurgery at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from January 2018 to June 2021. All patients of lumbar herniated intervertebral disc subjected for surgery were included. Recurrent prolapsed intervertebral disc, Disc surgery requiring stabilization was excluded from the study. During surgery types of prolapsed intervertebral disc, level and operative time were noted. In the post-operative period Visual Analogue Scale was used to assess the change in severity of pain. Duration of hospital stay and the complications occurred were also noted. Results: The mean age of the study population was was 41.50 (±14.56) years ranging from 20 years to 79 years. The commonest lumbar prolapsed intervertebral disc was at L4-L5 level. The mean operative time was 42 minutes excluding the time for anaesthesia preparation. There was statistically significant difference (p<0.001) in pre-operative and post-operative Visual Analogue Scale. Mean duration of hospital stay was 5.58 (1.87) days. Conclusion: A through workup and surgical planning is associated with better outcome avoiding complications in minimal invasive open micro lumbar discectomy.  


2021 ◽  
Vol 10 (2) ◽  
pp. 63-64
Author(s):  
Sushmita Khanal ◽  
Sunil Babu Khanal

Guillain-Barre Syndrome has been reported as a rare side effect in the recipients of Johnson & Johnson®'s Janssen Ad26.COV2.S COVID-19 vaccine. We report a case of Guillain-Barre Syndrome in a 50 years old female following the administration of the aforementioned vaccine.


2021 ◽  
Vol 10 (2) ◽  
pp. 3-6
Author(s):  
Kewal Shrestha ◽  
Sujit Kumar Bhattacharjee ◽  
Kumari Ragani Yadav

Background: Dermatophytes are keratinophilic and keratinolytic fungi which are responsible for dermatophytosis. There are three genera of dermatophytes; Trichophyton, Microsporum and Epidermophyton. As they have affinity to keratin rich tissue, they produce dermal inflammatory response, intense itching and cosmetically poor appearance. The varied clinical presentation of tinea results in delay in diagnosis, poor compliance in follow up of cases, and consequently spread of infection in the community has rekindled interest in rapid identification of species. Materials and Methods: A hospital based cross sectional study was carried out in the department of Microbiology, Nobel medical college from January 2019 to December 2019. Clinically suspected 200 cases of dermatophytosis attending Out Patient Department were studied. Isolation and identification was done by various tests like macroscopic, microscopic and biochemical tests. Results: Out of 200 specimens, 138 (69%) were skin scraping, 42 (21%) were nail clipping and 20 (10%) were hair stubs. Highest incidence was seen in the age group 21-40 years with 115 (57.5%) cases followed by 41-60 years 46 (23%) cases. In our study male preponderance of 158 (79%) and female of 42 (21%) were seen. Tinea corporis was found to be the commonest clinical type with 96 (48%) cases followed by tinea unguinum, 42 (21%), Tinea cruris 10 (11.36%), Tinea capitis 5 (5.68%), Tinea faciei 4 (4.54%), Tinea pedis 2 (2.27%). Among the fungal isolates Trichophyton rubrum (67.04%) was the most common etiological agent followed by Trichophyton mentagrophytes (13.63%), Epidermophyton 10 (11.36%), Trichophyton violaceum 4 (4.54%) and Epidermophyton floccosum 3 (3.4%). Conclusion: The most common clinical presentation was tinea corporis followed by tinea unguinum. T. rubrum was the most common etiological agent of dermatophytosis


2021 ◽  
Vol 10 (2) ◽  
pp. 43-48
Author(s):  
Dhirendra Kumar Giri ◽  
Ajit Kumar Yadav

Background: Various modifications of the coronally displaced flap have been proposed in the literature with the attempt of treating gingival recession. This study is undertaken to evaluate the predictability of the modified coronally positioned flap in isolated gingival recession not only in terms of root coverage but also with the esthetic outcome. Materials and Methods: Fifteen isolated gingival recessions with at least 1mm of keratinized tissue apical to the defect were treated with a modified coronally advanced flap. All recessions fall into Miller class I. The clinical re-evaluation was performed 3 months and 1year after the surgery. Statistical analysis was performed using statistical application software (SPSS16.0). Multivariate ANOVA was used for analysis. Results: At the 1-year examination, the average root coverage was 94.6% of the pre-operative recession depth. There was a mean clinical attachment gain of 3.3±0.1 mm at 1 year follow-up.The average increase of keratinized tissue between the baseline and the 1-year follow-up amounted to 1.53±0.13 mm. Root coverage esthetic score (RES) was recorded at the end of follow-up period. 13/15 cases showed RES score of 9 and 2/15 cases showed RES score of 6. Conclusion: The modified coronally advanced surgical technique is effective in the treatment of isolated gingival recession in the upper jaw.


2021 ◽  
Vol 10 (2) ◽  
pp. 20-25
Author(s):  
Bhanubhakta Neupane ◽  
Gyanendra Man Singh Karki ◽  
Hanoon Pokhrel ◽  
Ashim Adhikari

Background: Pelvic organ prolapse in elder women causes sufficient morbidity and decreased quality of life. Despite age related comorbidities and decreased physiological capabilities, elder women with pelvic organ prolapse may be benefitted by surgical repair via vaginal route.The purpose of this study is to evaluate the safety of vaginal repair of pelvic organ prolapse in women of age 60 years or older. Materials and Methods: This hospital based analytical study was carried out in Birat Medical College Teaching Hospital from September 2020 to September 2021. Fifty-four patients aged 60 years or older with third and fourth degree pelvic organ prolapse were recruited for the study. Necessary information was obtained by self-structured questionnaire and entered into Microsoft Excel. Data was analyzed by SPSS version 22. Results: Fifty-four women with third or fourth degree prolapse with cystocele and rectocele underwent vaginal hysterectomy with anterior colporrhaphy with posterior colpoperineorrhaphy. No organ injury occurred during operation. There was no mortality or severe intraoperative or postoperative complications. Conclusion: Vaginal hysterectomy with pelvic floor repair for pelvic organ prolapse in women of 60 years or older is safe.


2021 ◽  
Vol 10 (2) ◽  
pp. 54-57
Author(s):  
Samir Singh

Background: Thyroid hormones are necessary for the growth and development, cellular differentiation, physiological function and metabolic regulation of almost all tissues in our body. Thyroid disorders are accompanied by alteration in hematological profile. This study aims to evaluate the effect of thyroid dysfunction on red blood cell parameters. Materials and Methods: This case-control observational study was conducted in the Department of Clinical Biochemistry, KIST Medical College and Teaching Hospital (KISTMCTH), Lalitpur, Nepal from January 2021 to June 2021.Total number of recruited subjects was 248, out of which 67 were labeled as hypothyroid, 7 were hyperthyroid and 174 were euthyroid as control. Subjects for all three groups were between 16-93 years old. Thyroid hormone profile of patients was determined by Siemens ADVIA Centaur CP immunoassay analyzer and hematological parameters by automated hematology analyzer Sysmex XN-550. Results were analyzed by SPSS 21 software and a chi-square test was applied to see significant differences among the groups. Results: The mean age of all study participants was 42.08±17.27 years and female constituted 74.6% of total subjects. Analysis of the data obtained a statistically significant difference in the mean hemoglobin (p<0.001) between hypothyroid and euthyroid groups. The difference was not significant for hemoglobin (p=0.252) among hyperthyroid and euthyroid groups. There was no statistical significant difference between thyroid cases and control for MCV, MCH and MCHC. Conclusion: The current study concluded that thyroid dysfunction have a significant effect on red blood cell parameters. Hematological parameters should be evaluated in patient with thyroid dysfunction.


2021 ◽  
Vol 10 (2) ◽  
pp. 15-19
Author(s):  
Rimu Mishra ◽  
Alok Acharya ◽  
Amar Kumar Yadav ◽  
Kaushal Sigdel

Background: Death in diabetes mellitus occurs mostly due to co-morbidities and complications resulting from diabetes. To reduce morbidity and mortality, awareness regarding diabetes and its complications is necessary. The aim of the study is to assess the health care practices and co-morbidities associated with the disease. Materials and Methods: A descriptive cross-sectional study was conducted at community level (Kharji ward number 4) at Biratnagar. All diagnosed patients of type II diabetes mellitus ≥ 18 years of age were enrolled for the study.  Data for socio-demographic factors and clinical status were collected by pretested semi structured Questionnaire. Random blood sugar was measured using a portable glucometer. Anthropometric measurements were done by measuring height and weight of participants and body mass index was calculated by standard formula. The data was analyzed using SPSS version 21.0. Results: Out of the total 205 participants, 55.7% were found to be within the age group of 45-64 years i.e. middle aged (55.6%). Almost equal participants of the male and female were found, 50.7% and 49.3% respectively. More participants were found of below poverty line 67.31%. More than half 47.8% of the participants were suffering from the diabetes for less than 5 years of duration. All most all participants 98.5% knew about diabetes and its complications. Majority of the respondents 62.4% were having co-morbidity, among them 34.6% of participants were having hypertension. Majority of the participants were utilizing private health care service 79%. Conclusion: The diabetic participants were mostly of middle age with almost equal number of male and female having adequate knowledge about diabetes. Hypertension was the most common co morbidity among participants and they preferred private health care service mostly.


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